Dermatopharmacology

Question 1

The skin is the _____ organ of the body
➢ The skin has a protective function of the body from:
* ________ fluctuations
* ________
* ___________
* _______ chemicals
* Organisms such as ?
➢ The skin of domestic animals is similar in ________ and ________ morphology

Answer 1

largest, Temperature, Allergens, Pollutants, Toxic, bacteria, fungi parasites and viruses, gross, histological

Question 2

Where is our skin the thickest?
* Over the _____
* Dorsum of the ?
* On the _____ and ____ surfaces of the feet

Answer 2

head, neck, back, and sacrum, plantar, palmar

Question 3

Where is our skin thinner?
* On the ventral _______
* ______ surface of the limbs
* ____ pinnae

Answer 3

abdomen, Medial, Inner

Question 4

Where is our skin the thinnest
* Over the _____

Answer 4

scrotum

Question 5

Name the two primary cell types exist in the epidermis:

Answer 5

→ keratinocyte origin
→ nonkeratinocyte origin

Question 6

Answer 6

Statrum corneum is the primary barrier to the pericutaneous obstruction?

Question 7

Drugs that are able to pass through the stratum ______ are subjected to drug-metabolizing enzymes similar to those in the liver. Which processes will occur here?

Answer 7

corneum

• Oxidation
• Reduction
• Hydrolysis
• Conjugation

Question 8

Describe how the skin functions as a barrier.

Answer 8

It prevents loss of water, electrolytes, and macromolecules. It excludes external agents (chemical, physical, and microbiologic agents.

Question 9

The __________ ________ is primarily responsible for this physical barrier
→ Abundance of _______
→ Configuration and content of intercellular _______.

Answer 9

stratum corneum, keratin, lipids

Lipids: are the most important for percutaneous ?

Question 10

Topically applied drugs can be absorbed by three routes:
1. The _________ ______ ( ________ rather than _______ the cells)
2. Hair ______
3. ________ or _______ glands (that open into the hair follicles)
Movement of drug through the stratum corneum occurs by ?

Answer 10

stratum corneum, between, through, follicles, Sweat, sebaceous, passive diffusion

Question 11

The stratum corneum can be seen
as a wall in a “brick and mortar”
configuration (Elias, 1983).
Via the ___________ ________ ______ is
the primary route of penetration

Answer 11

intercellular lipid matrix

Question 12

Question 13

The permeability of __________ __________ through intact skin is greater than that of polar drugs

More drug is likely to pass through the skin of _______ haired animals (larger ________ of hair follicles)

Answer 13

lipophilic drugs , heavily, number

Question 14

Before a drug can be successfully delivered to the epidermis under the stratum corneum, the drug must?

Answer 14

• First move out of the vehicle and onto the surface of the stratum corneum
• Be able to penetrate the stratum corneum

Question 15

Drug movement and the skin.

Question 16

A vehicle is a substance in which a medicinally _______ agent is ______ administered. Occasionally
the vehicle is _______, but usually it is ______.

Answer 16

active, topically, therapeutic, inactive

Question 17

The physical and chemical properties of the vehicle will affect ________ of drug into the skin.

Answer 17

movement

Question 18

Only the __________ moiety of a weak acid or base is available for diffusion ______ the stratum corneum

The typical pH of skin ranges from ?
- Vehicles with different pH may have __________-________ absorption for drugs with pKa values in the range.
- The optimal vehicle is one in which the drug is ______ enough to enter into solution. However, if a drug is too ______ in a vehicle relative to the stratum corneum, the drug may _____ in the vehicle and only _____ release drug into the skin

Answer 18

nonionized, across, 4.2 to 7.3, species-specific, soluble, soluble, persist, slowly

Question 19

Other factors affecting percutaneous absorption?

Answer 19

• Molecular weight of the chemical
• Temperature (air)
• Blood flow
• Skin age

Question 20

Keratolytics ______ and _____ the stratum corneum → promote the ___________ removal

Answer 20

hydrate, soften, mechanical

Question 21

Keratoplastics normalize keratinization by ?

Answer 21

slowing basal cell proliferation

Question 22

Salicylic acid is used as ________ and __________. It has some mild _________, _________, and _________ actions

Answer 22

keratolytic, keratoplastic, antibacterial, antifungal, antipruritic

Question 23

Sulfur is _______ and ________. It has a mild follicular _______ action. Sulfur has ___________ and _________ effects

Answer 23

keratolytic, keratoplastic, flushing, antibacterial, antipruritic

Question 24

Coal tar is ________ and ________ and has good degreasing action. It is also frequently used in combination with ______ and _________ _____. Coal tar products should not be used in _____ → frequent ______ reactions. Commercial _______ are frequently used.

Answer 24

keratolytic, keratoplastic, sulfur, salicylic acid, felines, irritant, shampoos

Question 25

Benzoyl peroxide (2% to 5%) is a ?. It is a strong ______ → free radical generator. * Products for people contain ______ concentrations of benzoyl peroxide * Benzoyl peroxide is indicated in the treatment of _______ and ________

Answer 25

keratolytic, bactericidal, degreasing, and follicular flushing, oxidizer, higher, keratosis, pyodermas

Question 26

* Resorcinol is a _______ agent. It has __________ and _______ properties. It promotes the hydration of ______. It can be combined with another __________ (e.g., sulfur, salicylic acid)

Answer 26

keratolytic, bactericidal, fungicidal, keratin, keratolytic

Question 27

* Selenium sulfide is a _________ and __________ compound. Cell ________ and ________ formation are slowed. _______ _________ irritation may result if accidental contact occurs

Answer 27

keratolytic, keratoplastic, proliferation, sebum, Mucous membrane

Question 28

Antipruritics are used to provide __________ relief of itching. They relieve itching by four mechanisms: 1. The itching sensation can be ________ 2. The skin can be _______ 3. __________ ________ nerves can be anesthetized 4. ___________ agents used topically to treat pruritus

Answer 28

temporary, substituted, protected, Peripheral sensory, Biochemical

Question 29

How can the itching sensation can be substituted?

Answer 29

It can be substituted with another sensation (heat or cold) → Menthol, camphor, warm soaks or baths, ice packs

Question 30

How can the skin can be protected?

Answer 30

It can be protected from external factors → scratching, biting, irritants, changes in humidity or temperature (bandages or impermeable agents)

Question 31

How can peripheral sensory nerves can be anesthetized?

Answer 31

Use of local anesthetics: benzocaine, lidocaine, pramoxine (Dermacool)→ they can cause allergic sensitization

Question 32

How can biochemical agents used topically to treat pruritus?

Answer 32

the use of glucocorticoids

Question 33

Glucocorticoids * ________ glucocorticoids may not be as potent as their oral or injectable counterparts. * Glucorticoids ________ provider greater efficacy than creams * Topical glucocorticoids can be absorbed through the ____ and cause _______ effects → more likely with the ________ fluorinated agents, such as?

Answer 33

Topical, ointments, skin, systemic, potent, Betamethasone, dexamethasone, triamcinolone, flumethasone, and flucinolone

Question 34

There are many forms of glucocorticoids available for topical use: including use on extensions of the skin → ? Give an example. Highly potent preparations in any form should not be used on ________ skin

Answer 34

external ear canal and anal sacs * E.g. Triamcinolone (0.015% Genesis spray) has been formulated to be applied to the entire skin surface. It can also be used for spot treatment of pruritic regions abraded

Question 35

A number of products are used to _____ or ____ the skin to various degrees * Agents that cause ________ → rubefacients * Agents that cause ______ → irritants * Agents that cause _________ ________ → vesicants Caustics are _________ agents that destroy tissue after one or more applications. Examples?

Answer 35

inflame, irritate, hyperemia, inflammation, cutaneous blisters corrosive Camphor, coal tar, creosote, menthol, methyl salicylate, iodine, mercuric iodine, alcohols, and pine tar Coal tar: What did she say?

Question 36

Coal tar is the most widely used in veterinary medicine * It is a by-product of ?

Answer 36

bituminous coal distillation. Coal tar decreases epidermal synthesis of DNA

Question 37

Escharotics are _______ that precipitate proteins to form a _____, and eventually a _____. Examples include?

Answer 37

corrosives, crust, scar, Glacial acetic acid, aluminium chloride, gentian violet, phenol, salicylic acid, and silver nitrate

Question 38

Irritant products have been used empirically for many centuries. The proposed mode of action: * To mask _______ to _______ pain by milder pain caused by the application * To induce a healing action on ______ wounds → Menthol-containing products are sometimes used to treat? → Capsaicin has been used _______ on humans for relieving arthritis pain In dogs, it also has been used to treat ?

Answer 38

moderate, severe, chronic, acral lick dermatitis in dogs, topically, acral lick dermatitis

Question 39

________, ________, _________ can be effective in the treatment of infectious skin diseases. Many antibiotics are available in topical form as ointments, such as? ➢ Often these drugs are available in ________ with each other or with _____. ________ therapy of dermatophytosis in dogs and cats is not highly effective because of the ______ hair coat → unable to reach the site of _______ in adequate concentrations

Answer 39

Alcohol, iodine, chlorhexidine, Neomycin, bacitracin, polymyxin B, gramicidin, and nitrofurazone combination, steroids, Topical, thick, infection

Question 40

Amphotericin B (Fungizone) is available in what forms? What is it used to treat?

Answer 40

3% cream, lotion or oinment used for Candida infections

Question 41

Chlorhexidine is a mild _______ and _______. It is available in what forms? Is it effective by itself?

Answer 41

antifungal, antibacterial as a rinse or shampoo (1% to 4%). By itself it is not very effective for the treatment of dermaphytosis

Question 42

What combinations can be used to treat Malassezia dermatitis?

Answer 42

New combinations combined with chlorhexidine and miconazole (Malaseb rinse) or ketoconazole (Ketochlor) shampoo can be used for Malassezia dermatitis

Question 43

Clotrimazole 1% (Lotrimin, Veltrim) is effective against ?

Answer 43

dermatophytes, Candida and Malassezia

Question 44

Miconazole is available in what forms? What is it used to treat?

Answer 44

1. as a 2% cream or 1% lotion (Conofite and Resizole) and shampoo (Dermazole) 2. It is effective against dermatophytes, Candida and Malassezia

Question 45

Nystatin (oinment or cream) is effective against ? What is it not effective against?

Answer 45

some yeast and some dermatophytes but not Malassezia species

Question 46

Sulfur is effective against ?

Answer 46

dermatophytes and may be used for localized or generalized dermatophytosis (LymDyp)

Question 47

Cats may become ill if they groom after treatment (_______) → Elizabethan collar until the product is dry. Lime sulfur dip is also _______ and ________ (_____ effective). Strong ______ (owner compliance may be weak)

Answer 47

sulfur, antiparasitic, antipruritic, cost, odor

Question 48

Thiabendazole is effective for _________ and some ______, including Malassezia. Tresaderm, a combination product with ________, and __________ is best used for local lesions.

Answer 48

dermatophytes, yeast, neomycin, dexamethasone

Question 49

The combined of __________ and _________ therapy should be used with caution

Answer 49

corticosteroid, antifungal

Question 50

Antiparasitics are available as?

Answer 50

* Sprays * Powders * Shampoo * Foams * Spot-ons * Dip

Question 51

Sprays may have _______ effect depending on the _______ compound and _________.

Answer 51

residual, active, concentration

Question 52

Shampoos have a _____ residual effect and must stay on the skin at least ___ minutes (to kill ____ and ____)

Answer 52

little, 10, fleas, ticks

Question 53

Spot-on products are commonly used as _________-spectrum _________ agents. What makes them the preferred products?

Answer 53

broad, antiparasitic Ease of use and efficacy make them a preferred product.

Question 54

Powders are _____ formulation but must be _______ applied

Answer 54

safest, frequently

Question 55

Active ingredients (?) in shampoo formulations are not intended to be absorbed _______. Any factor that would increase the absorption may result in system _____ * ______ are especially susceptible to the toxicities of certain parasiticides → Only the products intended for use in cats should be used! * Toxicity can follow ingestion (_______) or ________ absorption. Toxicity can manifest as ? → treatment is _______ but should include ________.

Answer 55

pyrethrin, pyrethroids, carbaryl, systematically, toxicity, Cats, grooming, percutaneous, salivation, tremors, and seizures, symptomatic, bathing

Question 56

Spot-on products act as _______ and some are effective against the _______ stages . They are applied to the _______ area from where they diffuse over the body → some products are intended to be ______ absorbed

Answer 56

adulticides, juvenile, infrascapular, systemically

Question 57

Name the topical antiparasitic products

Answer 57

Imidacloprid (Advantage), fipronil (Frontline), selamectin (Revolution), metaflumazone (ProMeris), and dinotefuran (Vectra 3D)

Question 58

______ ______ have limited efficacy → carbaryl, pyrethrin, or organophosphates. (????) Collars occasionally cause _______ reactions. Ingestion of the collar is associated with _____ toxicity → __________ can be an effective antidote

Answer 58

Flea collars, irritation, acute, Yohimbine

Question 59

Collars containing _______ (_______) act to "sterilize" the fleas → they not kill adults fleas

Answer 59

methoprene, Ovitrol

Question 60

Collars containing _______ (______) are effective against ticks but not fleas

Answer 60

amitraz, Preventic

Question 61

Pyrethrins are extracts from ____________ flower. MOA → disrupt _______ function by prolonging ____ in nerve membrane. They kill?. They are available in many formulations → ______ properties

Answer 61

chrysanthemum, neurologic, Na+ , fleas, flies, lice, cheyletiella, otodectes, and mosquitoes, repellent

Question 62

Pyrethroids are synthetic analogs of _________ (same _____). They have ________ knockdown than pyrethrins. Some formulations combine them. Permethrins are available as 0.05% to 25% (flea sprays) but also up to 65% as spot flea and tick products

Answer 62

pyrethrins, MOA, slower

Question 63

Carbamates such as _______ are available in sprays, dips, collars, and sprays. Toxicity of carbamates reflects overstimulation of the _________ system → it should be treated with ?

Answer 63

carbaryl, parasympathetic, atropine and 2-pyridine aldoxime methylchloride

Question 64

Organophosphates are the most _____ _________ used in veterinary medicine. These agents should not be used around ______ (with one exception). It is important to avoid _______ exposure if animals are exposed to these agents (in lawn and garden preparations

Answer 64

toxic, insecticides, cats, cumulative

Question 65

Chlorpyrifos (Oph) (Dursban, Duratrol) used for flea _____ and ____. ________, used for enviromental flea and tick control. _______, used on both cats and dogs and often combined with other insecticides. ___________ (?) useful for flea control and sometimes used for _____.

Answer 65

sprays, dips, Diazinon, Malathion, Phosmet (Paramite Dip),, scabies

Question 66

______________ are disappearing from the market because of concerns of safety of animals and human beings

Answer 66

Organophosphates

Question 67

___________ (?) is a synthetic molecule in the phenylpyrazole familiy. It acts at _________ receptors and inhibits GABA-regulated _______ flux into the nerve cell.

Answer 67

Fipronil (Frontline), gamma- aminobutyric acid (GABA), chloride

Question 68

Fipronil It is a ____ adulticide and has efficacy against _____. It may also be effective in preventing _____ mite infestation. Available as an on-animal _____ or as a ____-on product. Frontline Plus contains ______ and _______ for its ovicidal properties

Answer 68

flea, ticks, scabies, spray, spot, fipronil, methoprene

Question 69

___________ (?) and combined with ___________ (?) is a spot-on application agent that kills adults fleas → It prevents _________ binding of _____, leading to ________ paralysis of the flea. It must be applied every ____ days to be effective

Answer 69

Imidacloprid (Advantage), permethrin (K9 Advantix), postsynaptic, ACh, respiratory, 30

Question 70

K9 Advantix provides efficacy against ___ and ______ → to be used only in ___.

Answer 70

ticks, mosquitoes, dogs

Question 71

_________ and ___________ (?) combination is available in a spot-on formulation for dogs and cats (7 and 9 weeks). It is used to treat ?

Answer 71

Imidacloprid and moxidectin (Advantage Multi), fleas, heartworm prevention, intestinal worms and ear mites

Question 72

Selamectine (Revolution) is available as a ____-___ formulation. It is used for the treatment of ?

Answer 72

spot-on, fleas, heartworm prevention, tick (Dermacentor sp.) infestation, sarcoptes (scabies), and octodectes (ear mites) for dogs (6 weeks)

Question 73

In____ (__ weeks), selamectine is approved for the treatment of ?

Answer 73

cats, 8, fleas, heartworm prevention, octodectes, roundworms, and hookworms

Question 74

Amitraz (Mitaban) is a monoamine oxidase _______. It is a licensed product for treatment of generalized ________. Off-label use against ___ and _____.

Answer 74

inhibitor, demodicosis, scabies, ticks

Question 75

Amitraz rapidily oxidizes on exposure to ____ and ___ → the ________ product is more toxic than the parent compound. It should be mixed fresh and the entire contents should be used

Answer 75

light, air, breakdown

Question 76

The large animal form of _____ (_____) should not be use in small animals

Answer 76

amitraz, Taktic

Question 77

ProMeris for dogs is a spot-on formulation containing _____ and _______. It has been approved to treat localized and generalized _________ in dogs (older than __ weeks). It is effective for _____ and ____

Answer 77

amitraz, metaflumazone, demodicosis, 8, fleas, ticks

Question 78

ProMeris for cats (8 weeks or older) does not contain _____ and is for the treatment of __ only

Answer 78

amitraz, fleas

Question 79

The combination product containing __________, ________, and _________ (Vectra 3D, Summit VetPharm) has been approved for use on dogs (older than ___ weeks). It is a ____-__ product and is effective against _____ and _____ and repels and kills _____ (monthly application). The feline formulation does not contain ________ (__ weeks )

Answer 79

dinotefuran, permethrin, and pyriproxyfen, 7, fleas, ticks, mosquitoes, permethrin, 8

Question 80

There are a small number of drug products that are designed to be applied to the skin and absorbed transdermally → high plasma concentrations to produce systemic effects * It is easier to administer drugs transdermally * Drug delivery can be sustained * Fewer factors complicating transdermal drug absoption

Answer 80

STOPPED HERE

Question 81

Not all drugs may be administered transdermally. The drug should not be irritating to the skin and should be transdermally bioavailable

Question 82

Some products used in veterinary medicine (not intended for TDA) can result in systemic absorption in the _______ treating the animal * ________ * All ________ drugs * ___________ oinment * All _________ (dips and shampoos) They should be handled with ________ gloves TDA = transdermal absorption

Answer 82

person DMSO, anticancer, Nitroglycerin, antiparasitics, nonpermeable

Question 83

Nitroglycerin oinment → relaxes vascular _______ muscle (primarily on the ____ side). It is used on ____ and ____ to treat ________ _____. It is applied to ______ areas (i.e., axillary, inguinal, or inside the ears). Onset of action is approx. One ___

Answer 83

smooth, venus, dogs, cats, cardiogenic, edema, glabrous, hour

Question 84

Fentanyl, a _______ ______ available in transdermal patches has proved to be an effective and safe alternative for control of pain in ___ and _____

Answer 84

narcotic, analgesic, dogs, cats

Question 85

Selamectin and systemic insecticides

Question 86

____________, __________, and __________ transdermal patches are available for use in human patients to treat motion sickness, angina, and hypertension, respectively.

Answer 86

Scopolamine, nitroglycerin, clonidine